Nursing Homes|Nursing Home Abuse|Assisted Living Facilities

Monday, February 3, 2014

Most people start thinking about the possibility of needing nursing care asf they hit middle age. Many have family or family who needed home health care, assisted living, or a nursing home. At this time, people learn about the high cost of long term care, and they wonder how it gets paid for.

Consider this. Full time nursing homes can cost $50,000 a year or more. Home health care may not be that much less, depending upon the amount of services needed. Assisted living facilities cost less, but may still be a lot more than it costs to live on your own. And the government estimates that 40% of people who turn 65 will need some sort of nursing care during retirement years.

How does this get paid for? Medicare, the federal health insurance for seniors and disabled people, only pays for short term care. Medicaid does pay for nursing homes, and in fact pays for half of all of thee costs in the US. But in order to qualify for Medicaid, a person has to deplete most of their assets.

So some people purchase a long term care insurance (LTCi) policy because they want to protect their savings in case they need to go to a nursing home. There are also alternative ways to plan for this which other choose. And many people have not done any planning at all.

Disadvantages of Long Term Care Insurance

Who do some people choose LTCi alternatives? Why do many people do nothing? Look at some things that they may consider.

Insurance exists to manage risks. When you purchase an auto insurance policy, you hope you will not have to use it. With most LTC policies, it is the same. You could pay premiums for years, never need it, and get nothing out of your policy except the security of knowing you have it. Some LTC policies may have a return of premium feature but it is not common.

LTCi policies are complicated, and there are many different types. Some are more useful and flexible than others. So some types of coverage may not help you for the particular situation you are in. For instance, you may have purchased a policy that only covers a nursing home. But an illness may only require adult day care or home health care. Again, some policies will cover different types of care so you, or your family, can make a choice when the time comes.

Premiums are lower for younger and healthier people, but can go up over time. If you cannot afford to pay premiums when you get older, it will not do you any good if you have to discontinue coverage. You have to make sure that you can afford the policy.

Advantages of Long Term Care Insurance

Of course, a lot of people do think LTCi is a great choice to make sure they have protected their assets.. And some features may even help them before they ever need to use it.

Some policies are tax deductible. Tax qualified plans can be deducted when you file taxes now. This makes the real cost of premiums lower than the price a company charges.

Assets are protected. If you want to preserve a lifetime of savings for yourself, your spouse, or your heirs, long term care is one obvious way to do this. With the right policy, you will not be forced to spend down your entire estate before you qualify for Medicaid.

You will have choices. Not every nursing facility or provider accepts Medicaid. You will be able to choose your private nursing home, assisted living facility, or home health care provider without worrying if they accept Medicaid payments. Some policies even offset the cost of care that is provided by family members.

How to Shop For Long Term Care Policies

It is important to understand how various policies work, how much they will cost, and which one will be the best plan for you. An experienced insurance agent can help you. You can also start looking by using a convenient online long term care insurance quote form. This will allow you to see competitive policies that are sold in your own local area.

Understanding my own Grandmother's absentmindedness in the beginning stages of her dementia was relatively easy. When she began to hallucinate is when things started to turn for the worse. I was walking with her in her assisted living facility when she told me about a recent hallucination.

"The other day, late in the afternoon, perhaps it was early evening, 3 people came into my room asking if they could share my bed and live with me," she said. "They had to ask Nancy (the admittance lady) first but I told them we couldn't all fit and they could not stay. I saw them as clear as day and then they vanished! It was then I recognized that perhaps they weren't real. But it sure seemed it was."

No wanting to upset my Grandmother, I said "I'm glad you recognized that!" Grandma said she agreed.

Those afternoon hallucinations marked the beginning of sundowning- early evening or late afternoon confusion in individuals with memory impairment or dementia. Regrettably, sundowning is not just hallucinations, it can be irrational ideas, agitation, wandering, and confusing dreams and reality. At times, people sundowning may become upset, suspicious, demanding, or disoriented.

My Grandmother did have a number of these behaviors. At one point she began to think people were robbing her room in the middle of the night while she slept. She began to forget names and people she'd known for years. She also began to shadowing me when I came to visit on a few occasions. She followed me so close that I almost tripped over her a few times, and telling some of the same stories again and again. So, what are some causes of sundowning?

Mental and physical exhaustion are two primary causes, in accordance to the Alzheimer's Association. Poor indoor and diminishing afternoon day light also contributes to sundowning. Another found cause are daytime naps.

LOOK OVER MEDICATION. A physician should review the medications as some may lead to sundowning. They also may prescribe a medication for sleep in order to prevent sundowning.

NAPPING IS DISCOURAGED. Daytime naps should be replaced with walking, group activities or some pet-therapy. After my Grandmother was unable to read she was still delighted listening to them read. One reader read a suspense-thriller. "I can't remember the title," my Grandmother said, "but it's got me on the edge of my seat."

STAY AWAY FROM CAFFEINE. Individuals with memory disease should abstain from caffeine. They also should not drink alcohol.

IMPROVE THE LIGHTING. People walking around the halls may be searching for the restroom, so be certain that all hallways have plenty of light. Night-lights also help the residents safely find the restroom.

LOWER AMBIANCE NOISE. Loud TVs, a blaring radio, and the noise of lots of people talking, can very well disturb and upset people with memory disease. Radios and TVs can be substituted with soothing CD music. Some facilities have a volunteer who comes in to play music and sing for residents.

REASSURE SECURITY. If the individual is concerned and upset about the hallucinations, be sure to assure them that they are in a secure and safe place where they are loved.

It is a federal, criminal offense to deprive nursing home residents of their freedom from abuse, neglect and misappropriation of property or funds. The laws apply to visitors, facility staff, volunteers, familymembers, guardians and other residents.

The Nursing Home Reform Act of 1987 entitles residents to live in an environment that improves or maintains their physical and mental health.

What is Abuse?

Nursing home abuse is any act that causes intentional harm or pain and can include psychological, physical or sexual attacks. Also included are intimidation, seclusion and corporal punishment (hitting, slapping, etc.).

Mental, psychological or emotional abuse may include berating, ridiculing, cursing, threatening, ignoring or deprivation of food, activities or visitors.

Physical abuse can result in both pain and visible injuries as a result of slapping, scratching, hitting, shoving, pinching, rough handling, unnecessary immobilization, or substandard care.

Rough handling may occur while administering medication, moving the patient or during other types of care such as bathing.

Substandard care often results in pressure sores, also known as bed sores, depression, incontinence or dehydration. In severe cases, more than one of these conditions are present.

Sexual abuse can occur as coercion to perform a sexual act, rape, improper touching or being forced to watch a sexual act.

What Qualifies as Neglect?

Nursing home neglect doesn't need to be intentional. It's the failure to provide the appropriate level of care, including the failure to react to any situation that can result in the resident's harm, such as failure to:

Promptly change disposable briefs or provide access to bed pan/toilet

Assist with eating, drinking, walking, bathing

Answer cries for help or call bells

Help resident participate in activities

Correctly position the resident in bed

Reporting an Incident

Your report should be in writing and dated. Keep a copy! Include every detail including the resident's name and age, facility name, employee(s), what, where, when, and all signs of abuse or neglect.

Start your complaint with the director of nursing, social worker and the facility's administrator. Ask them what, if any, other steps must be taken to have the incident investigated.

If a serious physical injury has occurred, contact law enforcement.

If the situation remains unresolved, contact your state ombudsman, local adult protective services agency and the state licensing agency.

Follow-up with the resident and all people or agencies investigating the incident. If possible, obtain written copies of the results of all investigations.

I had no idea how ill prepared I was to experience Detachment. Here is a film that plunges headfirst into the depths of disillusionment, despair, and failure and almost never resurfaces for air. You will experience emotions normally repressed during movie watching. You will be saddened, shocked, and above all, angered. You will see things you wouldn't ever want to see and hear things that should never be heard. You will wade through a sea of bleakness, desperately searching for some small shred of hope to cling on to. At the end of it all, you will be so psychologically drained that, for a time, it may seem as if you will never be happy again. At the same time, you will also get to thinking, and that's exactly why I'm recommending this movie so highly.

A few months ago, I snubbed my nose at the critically acclaimed thriller The Grey, an equally hopeless and depressing but also nihilistic story about men who must fight against wolves, and themselves, in the snowy Alaskan wilderness. Unlike that film, which reduced its compelling ideas into a cheap and shallow thriller, Detachment uses its desperation and despondency to make a point. I don't see it as a movie so much as a wakeup call, a way for audiences to understand not just the world but themselves as well. At its essence, it's an examination of behaviors that are perpetuated by people that have the power to stop it. It might not seem like they have the power. In fact, it might seem like absolutely everything is working against them. There's no question that rising above adversity is a challenge. Nevertheless, it's one that must be faced.

The main setting is an inner city public high school, one that exemplifies with horrifying detail the failure of the No Child Left Behind act of 2001. Most of the students are poorly educated, violent, and foulmouthed. They have no respect for others, but more to the point, they have no respect for themselves. They have, in fact, degenerated into pure apathy. This has rubbed off on the faculty, for they know that all their years of teaching and guidance haven't made the slightest difference. They're constantly berated by furious parents for being so lousy at their jobs. It's almost as if they have relinquished themselves of the responsibility of actually raising their own children. Is your son or daughter a problem? Don't take the necessary steps of working towards a solution - simply dump them off at school and let the teachers do the dirty work.

Bearing witness to all of this is a substitute teacher Henry Barthes (Adrien Brody). He struggles to make a difference, all the while knowing that he's failing miserably. He sees nothing but people who have given up, and he's within of inch of giving up on himself. His personal life is a mess; his grandfather (Louis Zorich), in the advances states of some kind of dementia, languishes in a nursing home staffed by people who simply don't care. He has flashbacks of a childhood scarred by the absence of a father, an alcoholic mother, and a deep tragedy. He eventually takes in an underage prostitute named Erica (Sami Gayle). He's saddened by her situation and even helps her in a few important regards, but he doesn't coddle her like a frightened puppy. He wants to get through to her that she has value as a person, that she's so much better than giving oral sex to men on the bus. He's also tortured by the fact that their arrangement can't last forever.

Several distinguished actors make appearances in this film, mostly as faculty members. These would include Marcia Gay Harden, Tim Blake Nelson, James Caan, Lucy Liu, Blythe Danner, Christina Hendricks, Isiah Whitlock, Jr., Bryan Cranston, and William Petersen. All are in various stages of professional and personal breakdown; Nelson plays a teacher who isn't noticed by anyone, Caan plays an administrator who can only get through the day on medication and biting wit, and Harden plays a woman who knows that the end is near. In one of the best scenes, Liu lashes out at a student for her disrespect and indifference at her own future. She gets nothing but kids like this day in and day out. What is the point of pointing out their academic shortcomings when they obviously won't take the steps to better themselves?

Of all the actors that appeared in the film, the most compelling is Betty Kaye as a student named Meredith, who observes the school through the lens of her camera. She creates dark collages with her photos. Her creativity is labeled by her unseen but clearly heard father as unnecessary teen angst. Believing only beautiful people are worthy of attention, he cruelly harps on her about her overeating, the way she dresses, and her social isolation. Meredith, an intelligent young woman, makes a connection with Barthes. Unfortunately, her self-esteem is so low that she misinterprets his encouragement as personal affection.

The film intercuts linear scenes with multiple narrative techniques, none more resonant than Barthes' documentary-style confessionals. The final scene begins with him reading the opening sentences from Edgar Allan Poe's "The Fall of the House of Usher," which should already tell you everything you need to know. The message of Detachment is simply one of responsibility and caring. If you're a parent, nurture your children and allow them to be themselves. Don't expect a school system to raise them for you - as they say, education begins at home. Before you point out someone else's flaws, first recognize your own. Understand that you're not perfect. Be thoughtful of others. And above all, know that you matter. There is no tragedy deeper than giving up on yourself.

With more people than ever surviving well past the ubiquitous three score years and ten (70), it has become apparent that not all of these people will be able to care for themselves full-time. Centers which cater only for older people are many, so this is possibly a good choice for a career. Nursing home jobs are nearly always being advertised and once someone has tried this out, they often go on to get more qualifications to enhance their career. A nursing home job could be just about anything, although the one thing that they have in common is that they will have close contact with the elderly.

Although the doctors and nurses employed by these places will take care of the medical needs of the inhabitants, there are many other positions which have to be filled to make sure that their lives are comfortable. Cleaners and housekeepers will keep the environment in good order while receptionists and social workers will ensure that the guests get all the information that they need. Visitors too will need some guidance and all of these jobs are available for those who just want to work around the older folk.

Nutritionists have a very important role to play of course, since the elderly often have a bad appetite or an inability to take certain foods, it is important that anything they eat is packed with nutrients enough to suffice their daily needs. Making it attractive and tempting too is also an art which should see them wanting to eat whatever is put in front of them. The nutritionist will certainly have a bachelors' degree in dietetics before they get a license to practice so this could take some time to achieve. Clever people start working in a home and study in their spare time so that they can achieve this important goal. Of course, this should make it much easier for them because they will get an insight into what an older person is like.

Social workers, on the other hand, ensure that the person is getting the care and treatment that they should have. Abuse is known to rear its ugly head in some places so the social worker is really an advocate for the elderly. They must have a masters' degree to fill this kind of position but once they have it, the salary is not so bad.

The one thing about working in a place like this is that the older person usually has a lot to impart to the younger generation. Stories of the past are like a living history of where we all came from and can be very interesting if they are given the opportunity to let everyone know.

As long as they are treated like human beings, and not some nuisance that is being kept just until they pass on, these people should be able to live out their lives peacefully and comfortably. With the help of all the ancillary workers, they should now be treated with respect for the last days of their lives.

Sunday, February 2, 2014

Everyone needs some kind of help at one point or another in their lives. Taking that help can be somewhat of a shot in the arm when it comes to pride. Assisted living homes allow the elder adult to keep their pride while accepting the help that they need.

There are tons of advantages to living in assisted living homes. There are several different models to choose from that are ideally situated to all personality types.

Companionship - Number One Advantage of Living Assisted

The truth of the matter is that with aging comes loneliness. Elderly people sometimes feel isolated and alone. Their children have long ago moved away and now have children and sometimes grandchildren of their own. Many older people simply feel forgotten in the busy lives of their families. By far the greatest advantage of living in one of the assisted living homes is companionship. This can literally make or break the quality of life. Having folks that have similar memories and histories living nearby or in the same home can really bolster the quality of life.

Making friends at any age and feeling like you are part of a group is sure to promote a thriving atmosphere. In addition to the friendships that are forged there is of course staff that is ever present that can provide advice, companionship, medication supervision and provide a doorway to an active lifestyle. Knowing that someone is there is a big part of the assisted living lifestyle.

Activities and Services

Assisted living homes usually have a full itinerary of activities that are available for participation. Of course the participation is not mandatory but many folks are geared up and ready to have some fun. Many elder adults can no longer drive, and one of the great features of living in assisted environment is the ability to be shuttled around, instead of waiting for a friend or relative to stop by for running errands, shopping, and visiting the doctor.

No one likes to be a burden; living in an assisted living environment removes that feeling of burdening someone else. It is all part of the agreement. Getting to the doctors when you need to get there is taken care of. Getting to the hair dresser or the barber shop is also taken care of.

Many homes plan day trips and some even offer extended trips. There are usually classes that are offered and exercise programs. Things that most elder adults would never venture to do on their own suddenly seem very possible in the group home environment.

Supervision

In some cases supervision is really needed. Adult group homes offer supervision without intrusion. This is an ideal situation for folks that really want to remain independence but can use a little overseeing.

There are so many advantages to living in one of the many adult group homes. They can really provide the perfect answer for the elder adult that can use a little help in life.

There may come a time in your life when you will want to or have to care for an elderly parent or loved one at home. In moments like these, a senior's health can be uncertain and can turn downward quickly and deteriorate. You may not be able to manage the amount of care and attention that's now needed. That's when you will be at a crossroad not knowing which direction to take. Do you continue caring for them or do you find them an assisted living facility? When facing the choice where to move their loved one into an assisted living facility or skilled nursing facility certainly isn't a decision that should be made hastily. Because there is no certain age criteria, one must look at the actual their physical and emotional health of the person in consideration.

What Is an Assisted Living Facility?

The Department of Public Health in California licenses all assisted living facilities, also commonly known and licensed as Residential Care Facilities for the Elderly. Most of these assisted living facilities provide 24-hour guardian care and attention. Some facilities may have a certified RN nurse that can offer skilled nursing when and if needed. In many cases these facilities are Medi-Cal and are Medicare certified. Some only accept private funds.

Outside a medical facility, an assisted living facility offers the maximal level of care offered for elder adults. The staff assists the residents with meals, getting dressed, bathing, getting in and out of bed, as well as assistance with administering medication. The facilities often have a weekly calendar of planned activities and social gatherings.

Indicators of Possible Assisted Living Admission

If your loved one is moving out of their home for the first time, it can be very traumatic to the individual relocating. In either case, expect some opposition especially if there are some distinguished "warning signs" that it's time to consider the move. Please note that only a doctor can detect the correct indications of an assisted living facility. When uncertain, contact their primary physician right away:

Disability: Seniors whom are physically disabled will benefit from this type of support. Ones who have limited mobility or that are utilizing wheelchairs will have more difficulty performing even simple tasks. Staff can help with taking care of personal needs, moving from one place to another and assist with walking without risking injury.

Ill health: Frequent hospitalizations or requiring constant observation because of an affliction, then consider a skilled nursing facility rather than an assisted living facility. Other life-threatening health problems such as a stroke, heart attack or hip fracture are also indicators that your loved one needs the care available from a nursing home staff.

Dementia and Alzheimer's Disease: a resident with Advanced stages of Alzheimer's Disease or type of dementia is better accommodated and at times, safer in a skilled nursing facility. Some of these "red flags" and warning signs may include; no longer being able to remember simple information or communicate clearly, unable to care for oneself, or the refusal to take prescribed medication.

In the end, you may not have a choice but to find a "home" for your senior. But as you can see, there are many benefits to choosing the best assisted living facility. Finding the "best" or actually the "right" facility doesn't come as an easy task. That's when Elder Care Referral agencies and services such as We Know A Place are useful resources. By finding an agency local to you, they will be familiar with the surrounding facilities. Once they have assessed the level of care needed, they in turn will help you determine which assisted living facility is the "best" one.